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Does concomitance of Hashimoto's disease and type 1 diabetes affect diabetes control and development of its
Grzegorz Szcześniak1, Patrycja Kozak-Nurczyk1, Piotr Dziemidok1
1Department of Diabetology, Institute of Rural Health, Lublin, Poland.
Insights
Hashimoto's disease (HD) in type 1 diabetes patients does not significantly impact diabetes control or chronic complication rates. However, impaired awareness of hypoglycemia is less common in patients with coexisting HD.
Area of Science:
- Endocrinology
- Immunology
- Metabolic Diseases
Background:
- Autoimmune diseases, like Hashimoto's disease (HD), can complicate diabetes management and prognosis.
- Type 1 diabetes (T1D) co-occurring with HD requires careful evaluation of disease control and complications.
Purpose of the Study:
- To compare diabetes control and the prevalence of chronic complications in type 1 diabetes patients with and without coexisting Hashimoto's disease.
Main Methods:
- Retrospective analysis of medical records for 188 type 1 diabetes patients.
- Diagnosis of Hashimoto's disease confirmed via medical history, thyroid peroxidase antibodies, hormone levels, and ultrasound.
- Statistical analysis performed using Statistica 10PL.
Main Results:
- Hashimoto's disease was present in 23% of T1D patients.
- No significant differences in mean HbA1c levels or the prevalence of most diabetes complications were observed between groups.
- Impaired awareness of hypoglycemia was significantly rarer in patients with coexisting HD (9% vs. 25%, p ≈ 0.04).
Conclusions:
- Coexistence of Hashimoto's disease does not significantly affect glycemic control or the development of long-term complications in type 1 diabetes.
- A notable finding is the reduced incidence of impaired hypoglycemia awareness in T1D patients with concurrent HD, suggesting a potential protective effect on autonomic neuropathy related to glucose sensing.
Introduction:
Autoimmune diseases concomitant with diabetes may complicate the treatment and adversely affect the prognosis. The most common is Hashimoto's disease (HD). We compared diabetes control and prevalence of chronic complications in type 1 diabetes patients differing in the coexistence of HD.
Material And Methods:
Medical records of 188 type 1 diabetics were analysed. Hashimoto's disease was diagnosed based on medical history, as well as determination of the levels of thyroid peroxidase antibodies, hormones and ultrasound examination. Statistical analysis was performed using Statistica 10PL.
Results:
HD was diagnosed in 43 (23%) patients. The mean HbA1c was 8.8 ±1.5% in the group with HD, and 9 ±1.6% in the group without HD (ns). The prevalence of diabetes complications was similar in both groups: ischaemic heart disease was diagnosed in 19% of patients with HD and 19% without HD, cerebral vascular insufficiency - 8% and 7%, peripheral neuropathy - 14% and 12%, sensory polyneuropathy - 47% and 46%, diabetic foot - 7% and 8%, Charcot osteoarthropathy - 7% and 2%, cardiovascular neuropathy - 21% and 28%, neuropathy of the gastrointestinal tract - 5% and 6%, nephropathy - 12% and 19%, retinopathy - 42% and 43%, and cataract in 28% and 19%, respectively. Impaired hypoglycaemia perception was rarer in the group with HD: 9% vs. 25% (p ≈ 0.04).
Conclusions:
Hashimoto's disease does not significantly affect the level of type 1 diabetes control or the development of its complications. Only autonomic neuropathy in the form of impaired awareness of hypoglycaemia is rarer in patients with that thyroiditis.
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